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General NPI Number Information
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NPI Number | 1962255018
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGY TALK
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Dates
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Enumeration Date | 04/09/2024
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Last Update Date | 04/09/2024
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Provider Practice Location Address
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Address Line | 3815 PELHAM ST
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City | DEARBORN
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State | MI
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Zip | 48124-3852
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Country | US
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Telephone | 313-265-0124
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 KINGSBURY AVE
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City | DEARBORN
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State | MI
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Zip | 48128-1134
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Country | US
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Telephone | 313-265-8871
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ADNAN JABER
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Credential | LP
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Telephone | 313-265-8871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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